Alcohol Overdose: Risks, Symptoms, and Prevention

Many people use alcohol to help them socialize or feel relaxed. But drinking too much in a short time period can lead to possibly deadly alcohol poisoning, or overdose. This article will help you better understand the risks of alcohol overdose, learn the signs and symptoms, and how you can help someone who is overdosing.

What Is Alcohol Overdose?

Alcohol overdose happens when there is so much alcohol in your bloodstream that it affects the part of your brain that controls basic life functions.¹ During overdose, breathing, heart rate, body temperature, and other life functions can shut down.¹ This can lead to brain damage and even death.¹

Excessive alcohol use caused more than 380 deaths per day from 2015 to 2019.² The 2018 National Health Interview Survey found that 25% of adults had at least 1 heavy drinking day in the previous year that put them at risk for alcohol overdose and its dangerous complications.³

What Is Excessive Drinking?

Excessive drinking is engaging in binge or heavy drinking, drinking when under age 21, or drinking while pregnant.⁴

Binge drinking is drinking an amount of alcohol that raises your blood alcohol concentration (BAC) to 0.08% or higher:^1,4

• For women, 4 or more drinks in 2 hours.
• For men, 5 or more drinks in 2 hours.

Heavy drinking means having:⁴

• For women, 8 or more drinks per week.
• For men, 15 or more drinks per week.

A standard drink is 1.5 ounces of liquor (for example: whiskey, gin, rum, vodka), 5 ounces of wine, 8 ounces of malt liquor, or 12 ounces of beer.^1,4

What Causes Alcohol Overdose?

Alcohol overdose is caused by drinking too much alcohol at a rate faster than your body can process (metabolize) it.¹ Everyone’s body is different. Depending on certain factors, some people may be able to have a few drinks in an hour and be okay, while others may overdose on the same amount. But in general, the more you drink, the greater your risk of severe symptoms.¹

Risk Factors for Alcohol Overdose

Factors that increase your chances of overdosing on alcohol include:^1,5

• Taking alcohol with other drugs, especially opioids, benzodiazepines, sleep aids, and over-the-counter antihistamines (such as Benadryl).
• Binge or high-intensity drinking. Remember that binge drinking is 4 or more drinks in 2 hours for women and 5 drinks in 2 hours for men. High-intensity drinking is drinking 2 to 3 times that amount.
• Being a teen or in college.
• Having less food in your stomach.
• Drinking stronger drinks.
• Having low tolerance (meaning your body isn’t used to the presence of alcohol).
• Drinking more alcohol than usual in a given time.

Alcohol Consumption Limits

Blood alcohol content, or BAC, measures the percentage of alcohol in your bloodstream.¹ Law enforcement officers use BAC to detect whether or not someone is unsafe to drive, but BAC does not necessarily otherwise tell you how impaired you are, especially if you have developed tolerance to alcohol’s effects.⁶ Even if you stop drinking when your BAC reaches 0.08%, your BAC can continue to rise as your body absorbs the remaining alcohol in your stomach and digestive tract.¹

These are some common symptoms, levels of impairment, and risks for various blood alcohol concentration levels:¹

• Between 0.02 and .08%: At the lower end of this range, you may feel relaxed, a little warmer, and may make poor judgments. As you get closer to the legal limit of .08%, you may have blurry vision, lose your balance, slur your speech, and have slow reaction times.
• Between 0.08 and .20%: At .08%, it is considered illegal and unsafe to drive. As BAC increases, in addition to all of the above symptoms, you may also start to lose control over your balance and have trouble walking and talking. This may lead to falls and other injuries.
• Above 0.20%: Confusion, nausea, and vomiting are likely to occur. You are at risk for many life-threatening dangers, such as choking or aspirating on vomit, blackouts, increased heart rate, irregular breathing, coma, and death.

It’s important to note that someone who regularly drinks heavily may have a high tolerance to the sedative and lethal effects of alcohol, and while the lethal BAC in a nontolerant person may be .40 to .50%, values exceeding these levels have been found in alcohol tolerant people arrested for drunk driving.⁷

Alcohol Overdose Complications

Alcohol has effects throughout the entire body and can cause serious short- and long-term health problems. Possible complications of alcohol overdose include:^1,5

• Alcoholic hepatitis and other liver diseases.
• Dangerous changes in heart rhythm.
• Heart attack or stroke.
• Traumatic injuries, such as from falls or car crashes.
• Long-term brain damage, coma, or death.
• Blackouts or memory gaps, including long-term amnesia.

Alcohol Overdose Symptoms

Drinking alcohol for its relaxing and tension-easing effects can be a pleasant social pastime. But when you lose track of your drinking, it can lead to overdose. Alcohol overdose can be dangerous and even deadly.¹ If you think someone has overdosed, call 911 for medical help and do not leave them alone.

Signs and symptoms of alcohol overdose include:¹

• Confusion.
• Trouble staying awake, or passing out and not being able to wake up.
• Vomiting or choking.
• Seizures.
• Very slow breathing (less than 8 breaths per minute).
• Slow or irregular breathing (10 seconds or more between breaths).
• Slowed heart rate.
• Cold or clammy skin.

How Can I Help Someone Having an Alcohol Overdose?

Whether for yourself or a loved one, quickly getting medical help is the best thing to do when someone has overdosed. There is no way to know how severe their body will react, and what you do for them could be the difference between life and death.

This is not the time to try “home remedies.” Contrary to popular belief, nothing can lower BAC except time; coffee, cold showers, “sleeping it off,” and chugging glasses of water will not help someone sober up any faster. In fact, by taking time to try home remedies, you could be risking their life.¹

While you are waiting for medical help to arrive, after calling 911, some helpful things you can do are:¹

• Stay with them. If they are conscious, they might fall, walk in front of a car, or do other dangerous activities. If they are unconscious or hardly awake, they may choke on vomit or suffer other emergencies. Do not leave them alone.
• Have them sit up and lean forward, or lay on their side with an ear to the ground to prevent choking.
• Collect any information you can about the person’s medical information, allergies, medications they are taking, how much they drank, or if they took any other substances. Having this information can be very helpful for the emergency medical team.
• Give them water if they are conscious to prevent dehydration.

How Is Alcohol Overdose Treated?

Depending on the timing of help and severity of alcohol overdose, medical treatments can include:^5,7

• Gastric lavage (also known as stomach pumping).
• IV fluids to help with dehydration.
• IV or oral glucose.
• IV or oral Vitamin B1 (thiamine).
• Airway protection, which can include intubation (inserting a breathing tube).

Preventing Alcohol Overdose

The 140,000 deaths every year due to alcohol overdose and the additional complications suffered can be prevented by avoiding excessive drinking.⁵ You can help yourself and others avoid alcohol poisoning by:⁵

• Limiting your own drinking and encourage others to as well. Responsible drinking is limited to 2 or fewer drinks in a day for men and 1 or less for women.
• Not drinking on an empty stomach.
• Avoiding drinking games that encourage rapid consumption of alcohol.
• Refusing to serve alcohol to minors or those who have already had too much.
• Not binge drinking.
• Educating yourself and others about the benefits of drinking less.
• Not using other substances while drinking.

Being responsible and thoughtful about alcohol use helps you stay safe. It is important to remember that alcohol is a drug that can have serious side effects. Though it can be an enjoyable addition to social gatherings, careless treatment can quickly lead to tragic consequences.

How to Find Treatment for Alcohol Misuse

Chronic excessive consumption of alcohol is dangerous. Alcohol misuse can lead to addiction, overdose, or even death. If you or a loved one is struggling with alcohol use disorder, it is never too late to get help. American Addiction Centers (AAC) is a leading provider of alcohol detox and addiction treatment in the United States, with treatment centers across the nation. Call to explore your options and get the help you deserve.